Signs of Approaching Death - Advice for Caregivers and Nurses

What signs of approaching death might we expect to witness? How do we know when someone is about to die? How can we recognise the moment? How can we prepare ourselves for what might be about to happen? How do we know how ill our loved ones or clients are?

“Listen to the dying. They will tell you everything you need to know about when they are dying. And it is easy to miss”. Elizabeth Kubler-Ross

This is a difficult subject, as no-one can definitely say when someone
is going to die. But these are questions which I am often asked. Many
people may have a dying relative and it is their first experience of
death. You may be a new carer or a recently qualified nurse having your
first experiences working on a busy ward. It can be frightening if you
don’t know what to expect.

Many ill people can linger for
months, others die peacefully in their sleep unexpectedly after a long
or short illness. You can only be guided by the doctor or experienced
nursing staff caring for the ill loved one. Advice from them is
essential, so don’t be afraid to ask questions.

Some sick loved
ones need more and more medication to ease the pain, and therefore
sleep more. Their breathing becomes more laboured and they may become
unconsicous for a few days and slip away quietly in their sleep. Chest
infections and pneumonia may occur.

Others may suffer a severe haemorrhage from an invasive cancer and death can occur in minutes.

No-one has a crystal ball to tell loved ones what is going to happen.

Signs of approaching death you may see include:

Breathing patterns change – perhaps laboured gasps

Strength of pulse rate – weakens

Temperature may become very low or very high

Loss of appetite and refusal to feed

Fluid intake and output may change

State of consciousness alters - they may slip into a coma

How Do I Know How Sick Someone Is?

This is another question I get asked frequently.

My criteria are:

Are they eating well?

Are they sleeping well?

Are they pain free?

If the answer is yes, then there is still some quality of life left, if no then it may be a blessing if death is imminent. It seems simplistic but really in later life it is very important.

Using these three criteria can reassure relatives if they think someone is worse than they are.

It can also be a comfort for relatives after someone dies if you can explain that their quality of life, based on these three criteria was no longer good.

Medical advances mean lots of difficult decisions when someone is dying . To feed or not to feed? To treat with antibiotics or not? Try not to go over and over decisions about whether you did the right thing. These are difficult questions even for medical professionals. You can only do what feels right at the time.

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